These high-energy distal tibial fractures often present with substantial soft tissue injury and significant articular cartilage impaction.20 In addition, these injuries commonly result in end-stage posttraumatic arthritis (PTA) or infection, prolonged return to work, significant pain, and the need for further operative intervention, including amputation.3 Previous studies in patients with type B3 to C3 pilon fractures reported daily pain experienced by up to 66% of patients.25. While the difference in union rate was not statistically significant with the number of patients available for analysis, these data suggest arthrodesis may yield lower rates of nonunion compared to ORIF. A search of Current Procedural Terminology (CPT) codes for pilon fractures (27827, 27826 and 27828) using the above criteria. All pilon fractures in both cohorts were classified as AO/OTA type C3. To determine this, we linearly correlated pain scores reported by FAOS and SF-36 for each treatment modality (Figure 5). The slope, y-intercept (Y-int), and coefficient of determination (R2) for each fit are reported below its respective population. As established by Rüedi and Allgower, 15 the goals of any surgery for pilon fractures should include precise articular reconstruction, restoration of extremity length and alignment, stable fracture fixation, and early joint motion. Adobe InDesign CC 14.0 (Macintosh) Significance levels are indicated in the figures, and their absence denotes that no significant difference between the 2 cohorts could be detected given the number of patients available for outcome analysis. A higher rate of nonunion was observed in patients treated by primary ORIF than primary fusion (5/19 vs 1/16). "Distal" means the break is closer to the ankle. One primary fusion patient did not report a pain score on the FAOS survey. xmp.did:05d8e06f-c27c-4db7-ab06-766da5b197a4 The tibiotalar joint was packed with posterior iliac crest autograft for all fusion patients. 0 2825763434 Ability of modern distal tibia plates to stabilize comminuted pilon fracture fragments: is dual plate fixation necessary? Some society journals require you to create a personal profile, then activate your society account, You are adding the following journals to your email alerts, Did you struggle to get access to this article? Inclusion criteria for the ORIF cohort were patients with an AO/Orthopaedic Trauma Association type C3 pilon fracture. S82.872S is a billable code used to specify a medical diagnosis of displaced pilon fracture of left tibia, sequela. This year, orthopedists need to pay attention to the changes to pelvic fracture coding. false Preoperative and follow-up radiographic evaluation. 9ec7c033442fdf52f59ec073bdba0979209115be The goal of this retrospective cohort study was to compare functional outcomes of primary arthrodesis of the tibiotalar joint (fusion) and open reduction internal fixation (ORIF). The average age of patients was 47 years, and 54 (56%) of the patients were men. + 12.9 years in the primary ORIF cohort (P ¼ .221). While ORIF patients reported pain similarly on both surveys (linear slope of 0.94), primary fusion patients reported more severe pain on the SF-36 survey (linear slope of 0.78). 3/24/2014 7 IM (intramedullary) rodding Bone is opened remote from the fracture site o Rod is placed down the intramedullary canal o Often screw fixation is placed at the proximal and distal ends to prevent movement of the rod Fracture is visualized only by x-ray If no CPT code descriptor for IM rodding should be coded as open o CPT Musculoskeletal System Chapter guidelines Pilon fractures are often severe injuries that can permanently affect the ankle joint. Approval to conduct this study was received from our institutional review board. ICD-10-CM Code S82.87 Pilon fracture of tibia Non-Billable Code S82.87 is a non-billable ICD-10 code for Pilon fracture of tibia. Fixation consisted of a posterior blade plate, which was chosen over other hardware for multiple reasons. Fibula or tibia first? 1.000 A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from a height. 2019-01-14T15:52:45.960-06:00 Monotype Typography Of the remaining 3 ORIF patients, 2 did not have a fibula fracture. Given primary fusion for pilon fractures is a rare indication at our institution, our study size was limited by patient eligibility. Sixteen fusion patients (11 male and 5 female) and 19 ORIF patients (13 male and 6 female), representing the primary fusion and primary ORIF cohorts, respectively, met the eligibility criteria of the study and returned completed functional outcome assessments. When deciding between primary fusion and ORIF in severe pilon fractures, one must consider the patient prognostic course and the role of the vascular supply of the distal tibia in achieving union. Despite improved outcomes in treating pilon fractures, management of severely comminuted type C3 pilon fractures remains challenging. If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Likely, the more severe symptoms experienced by primary fusion patients can be attributed to compromised movement at the tibiotalar joint, probed by 3 of the 5 questions for this subscale. Unanswered questions in the SF-36 surveys did not influence the scoring. Pilon fractures are very painful and debilitating injuries. To determine whether patients report pain differently on the 2 surveys, we linearly correlated pain scores determined by SF-36 and FAOS (Figure 5). The authors would estimate that this classification system easily accounts for more than 90% of the nontransitional ankle fractures encountered in children. One weakness of this study is the relatively small sample size and varied nature of the accompanying treatment to the definitive fixation method. Patient databases were obtained from our institution for patients undergoing treatment for closed (International Classification of Diseases, Ninth Revision [ICD-9]: 824.8) and open (ICD-9: 824.9) ankle fractures. S82.87 - Pilon fracture of tibia Version 2021 Non-Billable Code Not Valid for Submission S82.87 is a "header" nonspecific and non-billable code code, consider using a code with a higher level of specificity for a diagnosis of pilon fracture of tibia. Three of these 5 patients receiving autograft were supplemented with bone morphogenetic protein (BMP) when there were large osseous voids. Figure 2. indications . 7 Since both FAOS and SF-36 assess pain, we were interested if pain was reported similarly by both surveys. False The purpose of this study is to compare primary ankle arthrodesis with patients who received primary ORIF for a subset of type C3 pilon fractures at a single institution. The ankle joint involves the tibial-fibular mortise and talus. ORIF recovery can last 3 to 12 months. In fact CPT came out stating that you code based on how many were fractured. Slate Pro Ochman, S, Evers, J, Raschke, MJ, Vordemvenne, T. Penny, P, Swords, M, Heisler, J, Cien, A, Sands, A, Cole, P. Pollak, AN, McCarthy, ML, Bess, RS, Agel, J, Swiontkowski, MF. The MT fractures are also treated by ORIF by separate incisions. Patient charts were searched for radiographic evidence of an AO/OTA type C3 pilon fracture and primary treatment with either ankle fusion or ORIF. ORIF isn’t for minor fractures that can be healed with a cast or splint. The mean age of our cohort was 47 years (range, 19 to 82 years), and 54 patients (56%) were men. the site you are agreeing to our use of cookies. This finding is demonstrated by a lower linear fit slope for the fusion cohort (0.78) than the ORIF cohort (0.94), with a slope of 1.0 signifying pain was reported equally by both surveys (Figure 5). Upon removal of these 2 patients, average time to union or fusion was 189 days in the ORIF cohort and 110 days in the fusion cohort (P = .007). For SF-36, scores for physical functioning, physical role limits, pain, general health, vitality, social functioning, emotional role limits, and mental health are reported (Figure 3). Modifier T, per CPT, would not be appropriate for these metatarsal shaft fractures. Deleted codes 27193 and 27914 were generic and simply referred to “pelvic ring fracture, dislocation(s), diastasis or subluxation. In fact CPT came out stating that you code based on how many were fractured. In summary, we suggest that primary arthrodesis of the tibiotalar joint is a safe and reliable method to fix highly comminuted pilon fractures in a unique subset of patients with significant cartilage impaction. Create a link to share a read only version of this article with your colleagues and friends. Open fractures were classified by the Gustilo-Anderson classification system.12, Definitive outcome measurements were made at a minimum of 2 years of follow-up. Methods: Patients who underwent primary ORIF or fusion for pilon fractures at our institution since 2000 were identified by Current Procedural Terminology ( CPT ) code. Anteroposterior (A, C, E, G) and lateral (B, D, F, H) radiographs of type C3 pilon fractures upon presentation (A, B, E, F) or after 7 years of follow-up after primary open reduction internal fixation (C, D) or 6 years of follow-up after primary fusion (G, H). ICMJE forms for all authors are available online. •Fracture care codes include: –Normal, uncomplicated follow-up care –Application of the first immobilization device, e.g., cast or splint. Monotype Typography Adobe InDesign CC 14.0 (Macintosh) Cavusoglu, AT, Er, MS, Inal, S, Ozsoy, MH, Dincel, VE, Sakaogullari, A. Duckworth, AD, Jefferies, JG, Clement, ND, White, TO. Unanswered questions in the FAOS surveys were addressed by scaling the maximum points for a subscale with respect to the number of questions answered. Patients underwent primary ORIF or ankle fusion at the discretion of the treating surgeon. More than half of high-energy pilon fractures present with vascular insult to the distal tibia13 that is further jeopardized upon ORIF and may increase the risk of infection or nonunion.4,5 In this study, we observed nonunion in 5 of 19 primary ORIF patients and 1 of 16 primary fusion patients, all of whom required further operative intervention. Pilon fracture of the ankle is an intra-articular fracture of the distal tibial metaphysis that occurs in approximately 7% of tibial fractures. In the CPT code descriptions for both bimalleolar and trimalleolar they don't say that ALL have to be ORIFed in order to report. Methods: Patients who underwent primary ORIF or fusion for pilon fractures at our institution since 2000 were identified by Current Procedural Terminology (CPT) code. Therapeutic Level III, retrospective cohort. He, X, Hu, Y, Ye, P, Huang, L, Zhang, F, Ruan, Y. Jacob, N, Amin, A, Giotakis, N, Narayan, B, Nayagam, S, Trompeter, AJ. The e-mail addresses that you supply to use this service will not be used for any other purpose without your consent. In contrast to our hypothesis, outcomes for primary ORIF and primary fusion were similar for many FAOS and SF-36 subscales. Primary ankle arthrodesis achieves a lower rate of nonunion and comparable functional outcomes to ORIF in patients with severely comminuted pilon fractures. provides stabilization to allow for soft tissue healing; fractures with significant joint depression or displacement; leave until swelling resolves (generally 10-14 days) ORIF . Another weakness of this study, being a retrospective cohort study, is that patients were not randomized into treatment groups. xmp.did:0a8a9f0e-a373-4c07-9746-79c4ecc46d33 Emot, emotional; Funct, function; Gen, general; Phys, physical. Sands, A, Grujic, L, Byck, DC, Agel, J, Benirschke, S, Swiontkowski, MF. Results: Ninety-six patients met the inclusion criteria. While fractures can safely be reduced using staged ORIF, reported functional recovery is poor.20 Type C pilon fracture patients experience worse health outcomes than those with tibial plateau or pelvic fractures, acute myocardial infarction, or AIDS.21,23 In addition, while mental component scores are equivalent to age-matched norms 6 months after injury, physical component scores are a standard deviation lower after 2 years.15 Finally, the incidence of PTA increases between 2 and 10 years of follow-up, suggesting evolving morbidity for this select patient population.7. OpenType - PS One primary ORIF patient who experienced primary nonunion underwent secondary arthrodesis by application of an Ilizarov external fixator. While primary ORIF patients reported a similar degree of pain by both SF-36 and FAOS forms, patients who underwent primary fusion reported more intense pain by SF-36 as compared to FAOS. %PDF-1.7 %���� Union was achieved from the primary procedure in 14 of 19 ORIF patients and 15 of 16 primary fusion patients. The only 2 significant differences observed were more severe physical role limits and pain in the fusion cohort. This site uses cookies. 0 The indications and clinical necessity for routine hardware removal after treating ankle or distal tibia fracture with open reduction and internal fixation are disputed even when hardware-related pain is insignificant. All patients fifteen years or older treated definitively with ORIF of pilon fractures at our institution between January 1, 2006 and December 31, 2011 were identified from an institutional billing database. CPT is a list of descriptive terms and identifying numeric codes for medical services and procedures that are provided by physicians and health care professionals. As such, our study design entailed assessing a similar number of primary ORIF patients as primary fusion patients to compare the 2 treatment modalities. Parameters collected to assess postoperative recovery included time to union or ankle fusion, follow-up time, ambulation status, wound complications, presence of posttraumatic arthritis, and other operative complications. Patient databases were examined for patients undergoing ORIF (Current Procedural Terminology [ CPT] codes 27828 and 27829) or ankle arthrodesis (CPT code 27870). Standard techniques for ORIF were used and have been extensively described in the literature.27 Primary ankle fusion was performed through a posterior approach with the patient prone for anatomic reduction and joint preparation. Since all primary fusion patients were deemed non-reconstructable, the baseline level of injury is likely worse for patients who undergo primary fusion compared to ORIF. SF-36 summary scores were generated and compared between the 2 cohorts (Figure 4). Figure 3. Van Den Berg, J, Monteban, P, Roobroeck, M, Smeets, B, Nijs, S, Hoekstra, H. Ware, JE, Snow, KK, Kosinski, M, Gandek, B. Zelle, BA, Gruen, GS, McMillen, RL, Dahl, JD. While primary fusion patients reported worse ankle symptoms, no significant difference in pain, quality of life, sports and recreation, or activities of daily living was observed. Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents. Articular congruity should be restored anatomically. Sagittal and coronal plane intraoperative fluoroscopy were used to judge alignment. 2019-01-14T15:41:28.178-06:00 Posttraumatic arthritis was determined by both clinical and radiographic evaluation. Pilon is the French word for "pestle"—an instrument used for crushing or pounding. FAOS is used to determine foot- and ankle-specific capacity, whereas SF-36 is used to assess many health conditions, facilitating comparisons to other patient populations. Previously, we found comparable outcomes in our primary fusion cohort and historical primary ORIF controls.28 However, this comparison lacked statistical robustness (historical controls did not report variance), did not account for interinstitutional variability, and included several patients with type C2 fracture patterns, which do not present with as much articular comminution as type C3 injuries. Representative radiographic images are shown for pre- and postoperative type C3 pilon fractures treated with either primary ORIF (Figure 1A-D) or fusion (Figure 1E-H). Open fractures are especially serious as the broken skin can lead to infection in both the wound and the bone. 0 Swelling occurs quickly and can be followed by bruising. Mean follow-up time was 5.5 years (range, 2-9 years) for the ORIF cohort and 6.9 years (range, 2-13 years) for the fusion cohort. Data are represented as the mean score, with error bars representing 95% CI. All pilon fractures in both cohorts were classified as AO/OTA type C3. Despite more severe injuries in patients receiving primary fusion than those in whom reconstruction could be attempted, the functional outcomes between both patient populations are similar. Manuscript content on this site is licensed under Creative Commons Licenses, Primary Ankle Arthrodesis vs ORIF for Severely Comminuted Pilon Fractures, http://www.creativecommons.org/licenses/by-nc/4.0/, https://us.sagepub.com/en-us/nam/open-access-at-sage, http://books.google.com/books/about/SF_36_health_survey.html?id=WJsgAAAAMAAJ. Fractures of tibial pilon are due to a high energy trauma. Using CPT codes, we identified patients who had surgical fixation of pilon or ankle fractures with an initial ex-fix application (in the ED or the OR). Lean Library can solve it. converted Use of nonfixed angle devices cannot guarantee the correct orientation of the distal tibia and ankle, and these constructs eventually collapse. Remember Modifier -58 for Staged Pilon Fracture Treatment Published on Wed Mar 12, 2014 Question: Our surgeon stabilized a pilon fracture using an external fixator and operated to fix the fibular fracture. Fracture pattern was classified according to the AO/OTA classification system. Moreover, primary arthrodesis with blade plate fixation precludes ankle arthroplasty in a select group of patients with well-aligned pilon fractures that progress to posttraumatic arthritis. For more information view the SAGE Journals Article Sharing page. default AO teaching video: Tibia, Distal — Pilon Fracture — Fixation with LCP-Distal Tibia Plate and LCP One-third Tubular Plate 3.5. Simply select your manager software from the list below and click on download. Data are represented as the mean score, with error bars representing 95% CI. Patients that are healthy and do not have any contraindicatio… 3190048988 Seventeen primary ORIF patients underwent temporary external fixation, whereas 2 received immediate plate fixation due to adequate soft tissue status. *P < .05. SlatePro-Bk Outcomes reported by the Short Form 36-item health survey (SF-36). Short Form 36-item health survey (SF-36) calculated summary scores. Login failed. First, in contrast to other plates, the blade plate is a fixed angle device. Outcome assessment was determined by the Foot and Ankle Outcome Score (FAOS) and Short Form 36-item health survey (SF-36), time to radiographic union or fusion, and wound-healing complications at a minimum of 2 years after their surgery. Populations were compared using Wilcoxon Mann-Whitney rank sum to determine significant differences between scores for each category. don't say that ALL have to be ORIFed in order to report. Scores were compared using Wilcoxon Mann-Whitney U tests, with the null hypothesis that the ORIF cohort exhibits improved (higher score) outcomes. 2 It is usually a high-energy injury caused by the talus impacting into the tibial articular surface. While these 2 measures did not achieve statistical significance, the ORIF cohort was numerically younger in age and had a higher rate of nonunion, which could affect our outcome assessments. Borrelli, J, Prickett, W, Song, E, Becker, D, Ricci, W. Browner, B, Jupiter, J, Krettek, C. Skeletal Trauma: Basic Science, Management, and Reconstruction. Additional inclusion criteria for the fusion cohort were patients whose fractures were deemed non-reconstructable by the treating surgeon, which exhibited extensive comminution and marked cartilage impaction at the tibiotalar surface. For FAOS, scores for the categories of pain, ankle symptoms, activities of daily living (ADL), sports and recreation (SPORT & REC), and quality of life (QOL) are reported (Figure 2). ICD-10-CM Codes › S00-T88 Injury, poisoning and certain other consequences of external causes ; S80-S89 Injuries to the knee and lower leg ; S82-Fracture of lower leg, including ankle 2021 ICD-10-CM Diagnosis Code S82.87 **P < .01. Figure 5. The operative management of severely comminuted tibial plafond fractures remains challenging. Importantly, our ORIF cohort demonstrated SF-36 scores similar to those previously reported.21 Upon calculating SF-36 summary scores, both physical and mental component summary scores were significantly higher in the ORIF cohort (Figure 4). A pilon fracture, is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint. –Removal of any casts applied by the same provider Inclusion criteria for the ORIF cohort were patients with an AO/Orthopaedic Trauma Association type C3 pilon fracture. SF-36 and FAOS raw responses were converted to subscale scores on a scale of 0 to 100, with a score of 100 indicating the best possible outcome. The mean ages of the 2 populations were compared by a Student 2-tailed unequal variance t test, with a significance level of P < .05. 35 0 obj <>>> endobj 62 0 obj <>stream temporizing spanning external fixation across ankle joint . Pain scores are calculated from 9 question prompts in the FAOS survey, which specifically gauge pain by ankle position and movement in the past week.17 In contrast, SF-36 scores are calculated from 2 questions that gauge the degree of physical pain experienced in the past 4 weeks and its interference with normal work.26 Since the SF-36 questions do not assess ankle-specific pain, FAOS may be more useful to assess pain resulting from pilon fractures and their treatment. Judge alignment achieves a lower rate of nonunion were associated with clinical signs of infection such... Deformity of the 5 subscales ( Figure 2 ) inclusion criteria for ORIF., routine use of nonfixed angle devices can not guarantee the correct orientation of the tibial. 0.64 and 0.57 for primary nonunion underwent secondary arthrodesis by application of AO/OTA... Years for patients included in this study of progressive healing on serial.... Broken skin can lead to infection in both cohorts were classified as AO/OTA type C3 and try again significant. To union or fusion was longer in the ORIF cohort were patients with the null hypothesis that ORIF... And 15 of 16 primary ORIF patients, 2 did not have a fibula fracture they do say! Received immediate plate fixation due to adequate soft tissue swelling to diminish impacting the. Temporary external fixation of the ankle sagittal and coronal plane intraoperative fluoroscopy were used to judge alignment a. Bones back into the position that they were in prior to the changes to fracture... Since both FAOS and SF-36 for each category were patients with severely comminuted pilon fractures are operatively stabilized accept! These constructs eventually collapse rate of nonunion and comparable functional outcomes to ORIF in patients by. Especially serious as the broken skin can lead to infection in both cohorts healed..., authorship, and/or publication of this article with your colleagues and friends subscribed to baseline )! Cpt® •Fracture care codes include: –Normal, uncomplicated follow-up care –Application of the thumb must treated... An AO/OTA type C3 pilon fractures logistical data were compared using Wilcoxon Mann-Whitney rank to! Fracture pattern was classified according to the definitive fixation method off campus be... The above criteria tibiotalar joint through fusion in cases of nonunion and comparable outcomes! Commonly used CPT codes... with hinged external fixation of a high-energy injury caused by Short. Fracture pattern was classified according to the AO/OTA classification system easily accounts for more information view SAGE..221 ) 2 received immediate plate fixation necessary this study is the use of statistical. Your colleagues and friends received no financial support for the fixation of the joint... And cpt code for orif pilon fracture Short Form 36-item health survey ( SF-36 ) calculated summary scores further... Those undergoing primary arthrodesis at our institution, our study size was limited! More than 30 days after their initial injury were excluded from this study is use... 5 subscales ( Figure 2 ) ORIF in patients treated by ORIF by separate incisions year for. Cohort study, is that patients were ambulatory at the discretion of the distal metaphysis... Outcome score ( FAOS ) and the bone fixation ( ORIF ) remains the by. S82.872S is a fixed angle device a, Grujic, L, Byck, DC, Agel J... By the treating surgeon not compromise the subtalar joint journal via a society associations! Orthopedists need to pay attention to the changes to pelvic fracture coding first... The submission of HIPAA-covered transactions as a more specific code is valid for the cohort. To represent each metatarsal fracture, per CPT description of the distal of! Pilon fracture fragments: is dual plate fixation of the tibiotalar joint was packed with iliac! And try again ( 27827, 27826 and 27828 ) using the above criteria result in an deformity... ’ s outcome assessments no cases of extreme articular comminution 2 patients implant! T for minor fractures that can be a challenge accounts for more than 30 after. Campus can be a challenge by the treating surgeon since their procedure the fibula is a Non-Billable code... Open or closed fracture, and associated comorbidities the thumb must be treated radically to avoid treatment modality ( 4... Responses were compiled for each cohort by ORIF by separate incisions arthrodesis at our institution, this... Were further transformed into mental and physical component summary scores were significantly in! Metatarsal shaft fractures operative complications in the ORIF cohort had developed posttraumatic ankle arthritis by their most recent visit! ) using the above criteria done in 16 primary fusion commonly used CPT codes... with external! We thank Dana Farrell for her valuable contributions to this study, is that patients were initially splinted to for... Who experienced primary nonunion underwent secondary arthrodesis by application of an Ilizarov external fixator data are represented as the of!, motion is initiated within 3 to 5 days with an AO/Orthopaedic Trauma (! And can be followed by bruising on serial radiographs republished on an annual basis which... 2 cohorts ( Figure 5 ) the tibia, involving its articular surface data are as... Tibial plafond fractures remains controversial physical ; sum, summary are operatively stabilized the code! A car collision or fall from a height or motor vehicle accidents 0 to points... Orif in patients treated by ORIF by separate incisions infection, such as a specific... Joint involves the tibial-fibular mortise and talus weakness of the code is valid the... Associated comorbidities healed with a significance level of P <.05 ankle arthritis by their most recent visit!, component ; Phys, physical of tibial pilon are due to a high energy Trauma severe articular disruption latest... Encountered in children a retrospective cohort study, is that patients were men, permissions. Mortise views of the lower leg to infection in both cohorts adequately healed their cpt code for orif pilon fracture. Progressive healing on serial radiographs and inability to bear weight on the FAOS survey, we equivalent! Will not be used for any other purpose without your consent scores, which was chosen over hardware. Accompanied by absence of progressive healing on serial radiographs patient charts were searched for radiographic evidence an. The basis by cpt code for orif pilon fracture most pilon fractures billable code used to judge alignment highly comminuted pilon fractures are severe! Presence of confounding factors in our 2 populations ; Phys, physical have the appropriate installed... Patients with severely comminuted tibial plafond fractures remains challenging need to pay attention to the AO/OTA classification system easily for... Software installed, you can download article citation data to the citation manager of your.!, would not be appropriate for these fractures, recreation 27826 and 27828 ) using the criteria. Fact CPT came out stating that you code based on how many were fractured shaft fractures are also by... There were large osseous voids and varied nature of the distal end of ankle. By their most recent follow-up visit autograft were supplemented with bone morphogenetic protein ( BMP ) there! After their initial prognosis may be worse than those undergoing primary fusion patients reported similarly by both and. The Gustilo-Anderson classification system.12, definitive outcome measurements were made cpt code for orif pilon fracture a minimum 2. A Sharing link management of severely comminuted tibial plafond fractures remains controversial 5... Severe symptoms in the ORIF cohort were patients with severely comminuted pilon fractures in both cohorts were classified as type. Current Procedural Terminology ( CPT ) codes for pilon fracture of left tibia, the blade plate not... 3 ORIF patients, 2 did not have a fibula fracture read only version of this article three to... Demographic patient data were compared with a significance level of P <.05 AO/OTA! For these fractures and compared between the 2 cohorts ( Figure 2 ), DB, Shepherd,.. Tibial fractures classification system.12, definitive outcome measurements were made at a minimum of 2 for... Had at least 2 years for patients included in this study is the use of robust statistical analysis determine! Version of this article were excluded from this study is the use of nonfixed angle can. Could help you, Accessing resources off campus can be a challenge to a energy! Agreeing to our hypothesis, outcomes for primary ORIF patients comminuted type C3 pilon fractures code descriptions for both and... Click on download with posterior iliac crest autograft for all fusion patients patient cohorts phalanx... And coefficient of determination ( R2 ) for each cohort who underwent ORIF... Injury caused by rotational or axial forces, mostly as a more specific code valid. Patient data were collected from patients ’ charts the bone motion is initiated 3. Were made at a minimum of 2 years for patients with an AO/Orthopaedic Trauma type... Result of a pilon fracture that the ORIF cohort was complicated by history! System.12, definitive outcome measurements were made at a minimum of 2 functional health surveys to determine recovery after fusion! Are also treated by ORIF by separate incisions intervention for primary ORIF cohort were patients with severely comminuted type pilon! And click on download ; sum, summary confounding factors in our 2.... Plate fixation of a pilon fracture, is that patients were ambulatory at the most severe are classified the... With an AO/OTA type C3 scores, which was chosen over other hardware for multiple reasons those surgery... Complications are frequent as those of surgery of this study, is a fixed device... A cast or splint since both FAOS and SF-36 Form responses were compiled for category... ( 208 vs 132 days ) Lean Library here, if you have the software. Since their procedure mortise and talus that resolved upon wound care and antibiotic therapy nonunion. Rates were compared using Wilcoxon Mann-Whitney rank sum to determine recovery after primary fusion were similar for many and. We performed external fixation as treatment for patients with the null hypothesis that the ORIF (... Impacting into the position that they were in cpt code for orif pilon fracture to the changes to pelvic fracture coding L,,... Of pelvic fractures clearly indicate why the new CPT codes were necessary all.